This invention relates to storage and transfer of prescription medications, non-prescription pharmaceuticals, medical supplies and other similar items for patient care in a hospital, clinic, nursing home, or similar health care facility. The invention is more specifically directed to a medical dispensing system with improved security and reporting of what medications have been handled, when, and by whom. The invention is more particularly concerned with tracking access to medications at a hospital pharmacy, ward or floor medications cabinet or carousel, medications cart, or patient bedside cabinet.
In any hospital or clinic, or in wards or floors of the hospital or health center, controlled access cabinets, e.g., cabinets with latching drawers or so-called carousels with rotating compartments, are used for storage of pharmaceuticals and of other limited-access medical supplies. The medications prescribed for patients need to be conveniently accessible for the authorized nursing staff but also need to be protected from unauthorized access to prescription medications, controlled substances, and high-value medical supplies. Dispensing cabinets may have a number of pull-out drawers that each have a number of compartments, with the various medications stored in them. Preferably there should be some control of access once the drawer has been opened. The compartments may be filled or replenished by pharmacy staff, and later accessed by nursing staff to administer drugs or other items to patients according to prescription orders for the patients on a given medication route. The cabinet or carousel may also contain medical supplies and medications in amounts proper for the day to day needs of the medical staff and patients, for example, non-prescription medications and supplies, hypodermic needles and syringes, and other materials that may be needed.
For drug security reasons the hospital needs to maintain a record of which supplies and which medications are stored, and in what quantities, in which locking or non-locking compartments of one or more of the drawers, and to keep track of each given medication or supply item when it is transferred from cabinet to cart or administered from the cart or bedside cabinet to a given patient.
Modern medications dispensing cabinets and carts incorporate connections for access to the hospital's computerized medications administration system, and may incorporate control mechanisms with software for unlocking functions and inventory functions. These cabinets and carts are capable of IP addressable configurations for access to the hospital network, to a personal computer or tablet, or to a hand-held device.
The cabinets and carts also incorporate a video monitor, label printer capable of printing machine-readable (e.g., bar-coded) labels, and a bar-code reader or similar input device. The cabinets and carts can also incorporate sensors in its drawers or compartment to provide open-closed status for the compartments, and to detect when a medication package has been placed into it or removed from it.
Drug security and the prevention of drug diversion are major interest items and of high importance to hospital administrators, as drug diversion (i.e., theft) and medication errors have become common and need to be prevented. Accordingly, there is a need for an improved, more secure and more efficient way to transfer medications securely within hospital.
At present, the movement of medications within a medical treatment center can involve transfer between pharmacy and a ward of floor medications cabinet, transfer by nursing staff within the ward from the medications cabinet to a medications cart, and/or administration of the medications from the cart (or from a bedside cabinet in the patient room) to the patient. Also, the medications can be taken from the ward medications cabinet, one at a time or a few at a time, by nursing staff and carried, e.g., on a medications tray to a given patent for administration to the patient, or to a few patients on a given medications route in the ward or floor. The medications can be pulled by the nurse staff, obtaining multiple medications at one time for a given patient, labeling the medications containers, and placing them on the cart or tray. The specific nurse may need to log on to the medications cabinet and onto the medications cart, load the cart, and then deliver the medications to the patients on the route and administer the medications to each patient. Hospitals may have an electronic medication administration record software system (i.e., eMAR) to assist in ensuring that the right drug is administered at the right time and right amount on the right route to the right patient. However, the eMAR system does not track who has handled the medications at each stage, or when the medications were transferred to or from the pharmacy, the ward or floor cabinet (or carousel), the medications delivery cart, or the patient bedside cabinet.
In order to address these medications security issues, it is important that each time a medications is obtained from pharmacy, or from the floor or ward cabinet, that the prescription medication can be stored within an automatically labeled and individually locked patient drawer in the cart or in the bedside cabinet. Then when the time comes to administer the given medication to the patient on the medications care route, that the patient drawer or compartment can be accessed by the assigned nurse or staff member, who provides machine readable identity of both the care staff member and the patient. This needs to be accomplished in a way so that login time is minimized and access is limited only to medications for that one patient at the patient's bedside.